“They’re positive too often!” , says a primary care colleague about the Mood Disorders Questionnaire (MDQ). He’s right: about half of MDQ positives are false positives.Zimmerman
A newer screening tool has been developed (no money in my pocket; public domain) which:
- is at least as good as the MDQVasquez, Zaratiegui, Shabani.a, Shabani.b
- can theoretically increase predictive value to 80% or morePhelps
- is as easy to use as the MDQ.
The newer tool uses a validated screening questionnaire called the Bipolar Spectrum Diagnostic Scale (BSDS) plus screening for 14 other factors — like family history — that influence the likelihood of bipolar disorder.
This tool can be self-scored, for your patients who can handle a little math, and provides also provides a rough interpretation of the results. By the time you walk back in, the patient has completed the test, scored it, and has a rough idea of what their results mean. They has also read a plain-english, neutral presentation of the FDA warning about antidepressant-induced suicidality.
Thus if the test is clearly negative, patients are ready for treatment as “unipolar”: either a depression-focused psychotherapy or an antidepressant. If the test is intermediate or positive, patients are encouraged to learn more about bipolarity, e.g. on this site (the Diagnosis page, for starters).
For a detailed analysis of the complexities of interpreting a bipolar screening tool, see my page about using the MDQ in primary care. You can still get an MDQ here.
And no, I’m not making any money on the MoodCheck. It’s public sector — unlike the MDQ.